Minister's speech before the Canadian Medical Association's Annual General Meeting

August 17, Saskatoon, SK

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Thank you, Doctor Ouellette, for your kind introduction.

As most of you know, this marks my first address before the Canadian Medical Association's annual general meeting.

For Health Ministers of the past, this has been an occasion to reflect on what the last year brought, and what the next will bring; to take stock of achievements, and discuss our main challenges.

For me, it's all this and more.

In addition, I also want to talk about how who I am and where I'm from shapes the way I work and what I work for.

To begin, I never would have expected that we would be dealing with two issues so challenging as the global shortage of medical isotopes and H1N1 flu virus at the same time.

But thankfully, I'm playing from a position of strength.

I say so, because, even before H1N1 came about, we were ready with a pandemic plan on which officials have been working for more than a decade and updating every step of the way.

On the shortage of isotopes, this is a situation that we faced in the past - and so we were better prepared this time.

Of course, these issues aren't just challenges for me.

They are challenges for my provincial and territorial counterparts, for each one of you and for all frontline health professionals.

And this fact strengthens my position even more.

To explain why this is so requires me telling you a little bit about where I'm from and who I am.

As I'm sure most of you know, I was born and raised in the North.

Before entering federal politics, I served as Health Minister for Nunavut.

Some would say that being born along the Arctic coast in a small outpost camp, and being raised with Inuktitut as my first language, would hardly be considered auspicious beginnings for a career in national politics.

However, for me, my roots instilled a true sense of what is important.

They have grounded me in traditional values which have kept me strong, and which continue to guide me, even today.

For example:

Inuuqatigiitsiarniq means respect for others;

Piliriqatigiingniq means developing collaborative relationships and working together for a common purpose; and

Pilimmaksarniq stresses the importance of gaining knowledge.

These are concepts handed down to me from my elders.

They have taught me to respect and listen to different opinions and perspectives, even if I don't always agree.

And they have instilled in me the importance of collaborating with experts to gain the insight we need to achieve the best results for Canadians.

As federal Health Minister, especially in dealing with the serious issues now facing us, these concepts serve me very well.

Canada is a vast country with varying health issues - and by their very nature, health issues are multidimensional and complex.

Viable solutions don't come easily.

They come from hard work.

As Minister, I need to be in close touch with my counterparts and other experts to gain a clear view of the full picture.

As said in our H1N1 awareness campaign, knowledge truly is our best defence.

For this reason, it's a time for collaboration with my officials, with my provincial and territorial counterparts, with First Nations leaders, and of course, with frontline health professionals and the medical community.

In fact, that's what brings me here today.

The CMA comprises some of the best, brightest, compassionate people in this country.

All of you have worked so hard to get to where you are today.

Given your considerable abilities, I'm sure you all faced numerous options in choosing your individual paths.

I'm sure most of you could have become anything you wanted.

For example, you could have chosen careers in law, engineering or business administration.

Of course, in the end, you chose medicine.

Certainly, I think most of you would agree, it wasn't for the money.

Canadians and their families look to you when they're sick, and listen to you on how to keep healthy.

For Canadians, you truly are beacons of trust.

And for Canada's Health Ministers and officials at all levels, you are valued ambassadors and indispensable allies in our quest to minimize, as much as possible, the spread and impact of H1N1 flu virus.

As Doctors, you have a key role to play in preventing the spread of this virus, in treatment - and in educating your patients.

To support you, it's up to us to provide up-to-date information and guidelines.

In building and implementing the Canadian Pandemic Influenza Plan, our government's response has been rooted in collaboration, mobilization, information and communication.

We've been collaborating with partners including the WHO, national professional organizations, provinces and territories and First Nations, taking stock of important resources such as: medical supplies, antivirals, as well as healthcare worker and hospital availability.

We've been providing, and will continue providing financial and technical support, helping First Nations develop, test and revise community-level plans.

Knowing full well that there will be needs in harder-to-reach isolated communities, in collaboration with provinces and territories, we're pre-positioning antivirals in nursing stations serving remote and First Nations communities.

In addition, we'll continue working toward integrating our planning process with provinces and territories to support the seamless delivery of supplies.

Altogether, we've ensured that the National Antiviral Stockpile can be mobilized quickly and we've been working with GlaxoSmithKilne to advance the development process for a vaccine.

From the minute they started investigating samples from Mexico, our researchers have been working around the clock to gain new information on the virus, how it's spreading and how it's affecting patients.

In turn, we've been communicating with professionals like you in developing and sharing guidelines based upon our knowledge - and updating as we learn more.

And of course, we've made efforts to raise the awareness of all Canadians.

Our response has been thorough, and we're committed to developing it according to what we learn.

For example, we've learned that pregnant women and people with underlying conditions are more susceptible to serious consequences from the virus - and this knowledge is being translated into prevention and treatment efforts.

As well, when our data revealed high rates of hospitalization and intensive care admissions for children aged less than one, I issued an interim order authorizing the use of Tamiflu if needed.

In addition to the order, in collaboration with provincial and territorial colleagues, the Public Health Agency developed guidelines for physicians, which can be found at Fight flu.

Overall, our experience thus far has told us that, although well-equipped and well-prepared plans are in place, we need to continue improving our planning in real-time - making adjustments as we gain new knowledge.

With the possibility of a stronger second wave to come in the Fall, we need to maintain our vigilance - and we need you to stand together with us.

Of course, with Fall on the way, we're continuing to work with GSK on developing a safe and effective vaccine.

Right now, we're on track for having one ready by mid-November.

On August 6, we announced our intention to order 50.4 million doses of H1N1 vaccine; sufficient to meet the needs of Canadians.

Many are now asking the question of who gets vaccinated first?

We recognize that this is a complex decision and it's one we're not taking lightly.

As we further refine our vaccine plan, we'll build on the advice of partners including medical experts and the World Health Organization.

The vaccine will be available to all who need and want it.

People most in need will get it first, and we'll work to ensure the vaccine reaches Canadians whose needs are greatest in the most effective manner possible.

Also, as I've noted, we're gathering information to determine who is most affected by the virus and why - and this will inform our vaccine priority planning.

I want to reassure you that we're dedicated to continuing our collaborative approach.

As federal Health Minister, I put special priority in keeping close contact with my provincial and territorial counterparts, just as I do with First Nations leaders and medical professionals.

At a time like this, continuing cooperation between governments, international partners and professionals on the frontline, serves as our most valuable asset.

And as Minister, I want to thank the many of you who have already helped minimize the impact of H1N1 - and all who will help in the coming months.

Of course, as you all know, H1N1 is but one of two health challenges facing Canada and the world today - and but one of two for which a continuing collaborative approach is greatly needed.

As you well know, medical isotopes cannot be stockpiled.

As a result, distributing them is like delivering ice cubes from door to door on a hot summer day.

This is challenging enough on its own.

And today, we face a global shortage.

Faced with this unfortunate situation, our government has acted on several fronts:

• We're urgently reviewing approval requests for alternative isotopes, so healthcare providers can gain greater options as quickly as possible; and
• In collaboration with provinces, territories and medical experts, we've provided information, assisting healthcare professionals on things like: making best use of the existing supply; shifting to alternatives; and prioritizing patients who need testing most.

During this challenging situation, I personally wish to thank every doctor who has made use of Thallium-201 as an alternative for heart tests, and F-18-Sodium Fluoride as an alternative for bone scans.

In addition, I also want to recognize the efforts of Doctor Sandy McEwen who came on-board as my special advisor on this issue, and the Ad-Hoc Group of Experts on medical isotopes, including CMA members - Brian Sharfstein and Eve Ellman.

And last but not least, I join everyone here in recognizing - with gratitude and admiration - the incredible efforts of Canada's nuclear medicine community.

Not only do I thank them, but I'm sure you do as well, along with patients and their loved ones.

However, I want to make clear that while these efforts are commendable, I realise that - over the long term - more is needed.

This is why I want to reiterate that our government is working on a long-term solution, focusing on:

• Repairing the Chalk River reactor to resume safe and reliable operation as quickly as possible;
• Assessing further alternatives to Tc-99m;
• Continuing our work with international partners to increase production and coordinate shut-down periods; and
• Continuing collaboration with provinces, territories and the medical community, in supporting the highest possible quality of care.

As we work toward a long-term solution, I'm happy that governments, health sector leaders and the medical community have come together to do everything possible for patients.

For many of you here, this has meant shifting your schedules, working overtime - and so, once again, on behalf of our Government, I thank you all.

This is a situation we faced before and so, thanks to lessons learned, we were all better prepared, and your forward thinking helped the medical community cope for the good of patients and their families.

In my view, it's this kind of forward thinking that we need to see more of in healthcare and health policy.

The kind of thinking I'm talking about isn't restricted to governments and health professionals.

Instead, everyone has the ability to secure a healthier future.

Returning for a moment to H1N1, the best way to avoid catching this virus is for everyone to be extra-vigilant about washing hands, sneezing and coughing into your sleeve, and staying home when sick.

Of course, preventive actions serve us well not only in the short term but over the full term of our lives.

Chronic diseases represent the most significant causes of ill health, premature death and the most significant burden of health care costs.

With the help of health professionals, their families and communities, individuals choosing to eat better, exercise more and quit smoking will do something positive for their own health.

This in turn, would make it easier to focus even more resources on promoting health and curing illnesses which cannot be prevented.

At the same time, we recognize that more can be done to encourage all Canadians to access "healthy" foods and opportunities for physical activity.

Governments and other organizations can help by using policy, regulations, and other tools to create supportive environments that assist people to make healthier choices.

During my first appearance before the Standing Committee on Health, I said that "as Health Minister, I sincerely commit to working with other governments, First Nations and Inuit, and all stakeholders so the next generation of Canadians grow to be healthier than their parents, not less."

This is a pledge I want to renew before you today.

While I realize full well that I've spent the majority of my time talking to you about two very pressing issues, I wanted to end on the need to focus more strongly on keeping people well along with treating illness.

I think this is one the most important considerations for the future of health care.

As I explained earlier, where I'm from has a large impact on who I am, how I work and what I work for.

Growing up in the North and serving as Nunavut's Health Minister helped shape my vision of a future where health policy fully respects Benjamin Franklin's famous quote: "an ounce of prevention is worth a pound of cure."

It's also made me passionate about stressing the need to address the determinants of health.

We have many challenges in the North, some of which I have experienced personally, some of which I have encountered in my career.

We have the highest levels of violence against women in Canada, high suicide levels, substance abuse, poverty, and not enough housing.

In addition, the daily smoking rate for Inuit is 58 percent - that's three times higher than the national average.

And so, it's no coincidence that we have the highest rate of lung cancer in the world.

Encountering issues like this brought me to where I am today.

It's why, as Nunavut's Health Minister, I was proud to advance the territory's public health strategy and establish community-based health programs.

It's why, as federal Health Minister, I'm proud of the work we're doing to counter substance abuse among youth through the National Anti-Drug Strategy.

And it's why, in May, I was proud to table Bill C-32, an act proposing to close loopholes the tobacco industry is exploiting to entice young people to start smoking.

I know many of you here today were very supportive of this initiative in particular - and the need to provide a healthier future for children in general.

And I urge you to continue your efforts on this issue and others such as obesity and injury prevention for the good health of our society and the overall benefit of our country.

In closing now, I talked earlier about the decisions each of you made in finding your path.

Just as your decision to enter medicine wasn't based on money, neither was my decision to enter politics based on prestige or power.

The determining factor in your decision was most likely the same as it was in mine: the real chance to make a difference and be rewarded by the immeasurable satisfaction of saving lives and helping change lives for the better.

When faced by challenges such as those before us today, it's important for all of us to remember this - and to know, that the time to realise this ambition is now.

What may come this Fall is something that could test all of us - possibly to a limit we've never experienced.

Whatever may come, I stress that we'll best meet the challenge and serve Canadians by cooperating - the federal government together with the provinces, territories, Aboriginal leaders, and frontline medical professionals.

Whatever may come, collaboration has been the foundation for developing the Canadian Pandemic Influenza Plan and it's what will allow us to execute it most effectively.

Whatever may come, every Canadian is counting on our successful collaboration.

And, as Health Minister, I commit to walk with you down a path, guided, as always, by Inuuqatigiitsiarniq, Piliriqatigiingniq and Pilimmaksarniq.

Thank you, Qujannamiik.